If a move is in your Elder’s future there is much to consider. Since every Elder and their family bring their own story, it will be challenge to include each detail for consideration. Please use this blog entry and list as a beginning point for discussion and assistance. You have a journey ahead and it helps to have a place to start. This journey has components that include safety, medical, lifestyle, emotion, finances, and pragmatics. Seniors often view the move to an assisted living community as one of the biggest changes in their lifetime.
Many experience normal feelings of sadness, depression or anger. Some view the move in a more positive light and as a way to feel more secure that their care needs will be met and to unburden their advocates. Assisted living caregivers receive special training to meet the needs of the elder population. Families and advocates can work with staff and with seniors to help them adjust. There is often a busy social structure in place so residents can engage as much or as little as they desire. Activities address mental, physical, and social activities that are appropriate and matched to ability. Peer interaction and reminiscence can be very powerful: many seniors are surprised by how enjoyable and rewarding community living can be.
FINDING THE RIGHT NEIGHBORHOOD:
Please note I did not use the term senior living facility- would you want to move to a facility? Ask about state licensure- do not take another step if the facility is not licensed. There are both public and private resources that can assist families with finding the right fit for senior living. Individual resources can be found in through your state’s Department of Human Services website. Look for http://www.type in your state.gov/dhs. Private geriatric and medical case managers, usually nurses (like ElderCompass) and social workers, can also be hired to assist with a more personalized approach. Other services assist free of charge and receive their payment from the senior neighborhood where the client is placed in the form of a referral fee. Please see this link for an excellent and comprehensive check list of questions.
1. NEEDS ASSESSMENT:
Prior to being accepted in an assisted living neighborhood, an assessment is performed. This is done to clarify that the resident’s needs for care and socialization can be safely met. Usually a nurse will review medical history, perform a physical assessment and interview. Activities of daily living, mobility, eating/feeding, medication management, bathing, social needs, and memory care are evaluated to assure proper placement.
Most families are surprised at the high cost of living in assisted living neighborhoods. In the US, expect $1,000-$8,000/month charges. Fees vary based on the amount of support and care that is required. Facilities include rent/lease/ or purchase, then base their additional fees on personal care, medication administration, medical visits, meal plans, laundry, transportation, or security deposit. Each facility has their own fee schedule equation, be sure to take this into account when comparing. Also consider a roommate to decrease monthly cost; this may seem strange, but this arrangement can offer instant companionship and camaraderie, as well as another safety net. As an extra set of eyes is watching out for your aging loved one.
3. PAYMENT RESOURCES:
Assisted living communities are most-often private pay facilities; Medicare and private health insurances [Long term Care Insurance is a separate entity] do not cover the costs. There are ways to reduce out of pocket expenses, and even some financial assistance programs. Inquire about these with regards to financial assistance, and saving money: Veterans Aide and Assistance**, Shared Apartments, Family Involvement (like rides to medical appointments and medication administration), Long Term Insurance, if the senior has an existing policy (You can request an assessment if your senior now requires assisted living), Low Income Apartment availability, Reverse Mortgages (ElderCompass staff included this topic to ensure comprehensiveness, but we vary rarely find this the right solution and warn against elder fraud and whether this actually works in favor of families), and potentially Medicaid*.
*The individual state Medicaid requirements are extremely strict, but in some instances, may be instituted.
**It is advisable to obtain the initial consultation of a Veteran Accredited attorney, and or one versed in Medicaid to assess potential resources for care and housing.
4. MOVING-OUT, THEN IN:
Downsizing for a move to assisted living is a process- please see our earlier blog – 10 Ways…- for pointers and insights. Keep a file of pertinent housing and financial documents and have it with you at all times during this period of advocacy. Have your senior pick several of their favorite pieces of furniture, pictures, and art that will best fit in their new space; these items can make them feel more at home more quickly, and it gives them things to talk about with their new neighbors. Draw a scaled picture of the room to ensure desired furniture can fit safely. Make arrangements for the sale or distribution of older furniture and try to avoid expensive storage facility fees. There are Certified Move Managers that assist with moving and more – stay tuned for a blog entry detailing such service.
In the meantime, see this site. Change mailing address and send postcards to friends and family. If there is an empty house, be sure to arrange for lawn care and snow removal, clean out the house as time allows and throw out garbage a little at a time so the home looks lived-in. Turn off water in cold weather and drop heat to 55 degrees, notify neighbors and friends of vacant home, place lights with timers, and arrange for intermittent driveway traffic and mail checks.
5. TRANSITION NEEDS:
Many senior communities offer respite packages and weekend trials before people move-in. Another way to test the water is to eat several meals at the community. Once moved in, ensure your senior knows who their main contact is for questions and concerns. Be sure you too have a contact that is available 24/7. Establish a visiting schedule with friends, family and religious organization members so seniors feel secure and still have familiarity in their life. Try to participate with activities with other residents to facilitate friendships Know your senior’s laundry and bathing schedule and plan your visits at different times to ensure new processes are going smoothly.
As with any major transition there will be some stress. Most importantly, be present and make sure your senior knows you have helped to make the best decision for all parties involved to ensure safety and contentment.